Edward L Lyell, MA | |
9699 N Fairy Lilly Dr, Citrus Springs, FL 34433-4052 | |
(505) 730-6403 | |
Not Available |
Full Name | Edward L Lyell |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 9699 N Fairy Lilly Dr, Citrus Springs, Florida |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1487278982 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101Y00000X | Counselor | CCMH0171851 (New Mexico) | Secondary |
101YM0800X | Counselor - Mental Health | MH23167 (Florida) | Primary |
Entity Name | Brave Health Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821588674 PECOS PAC ID: 8123458981 Enrollment ID: O20200417001688 |
Mailing Address | Practice Location Address |
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Edward L Lyell, MA 7005 Prospect Pl Ne, Albuquerque, NM 87110-4311 Ph: (104) 200-6502 | Edward L Lyell, MA 9699 N Fairy Lilly Dr, Citrus Springs, FL 34433-4052 Ph: (505) 730-6403 |
Tina Johnson, LMHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 9676 N Jourden Dr, Citrus Springs, FL 34434 Phone: 352-651-4833 | |
Shilo Allene Wagner, MS MHC Counselor Medicare: Not Enrolled in Medicare Practice Location: 10156 N Academy Dr, Citrus Springs, FL 34434 Phone: 352-476-4311 | |
Michelle Pratt, Counselor Medicare: Not Enrolled in Medicare Practice Location: 984 W Almont Pl, Citrus Springs, FL 34434 Phone: 207-939-3669 |